Pregnancy Counselling

Pre-pregnancy Counselling or Planning is recommended. It is conducted before you conceive and while many women have normal pregnancies, pre-planning with Dr Turner improves the chances of a smooth pregnancy and a healthy baby.

By discussing your plans with Dr Turner prior to becoming pregnant you can optimise both the health of the mother as well as the baby during the term of pregnancy.

Pregnancy planning will

• Assess the mother for any illness and ensure vaccinations are current
• Allows time to resolve any medical issues before you become pregnant
• Helps to create a healthy environment for the foetus
• Helps in checking for possible risk factors or pre-existing diseases
• Can prevent birth defects as well as other pregnancy related problems
• Discuss the option of genetic testing of both partners to identify inheritable conditions that could occur in the baby.
• Review weight, diet and exercise program to optimise pregnancy outcomes

Counselling and care will help you to become emotionally and physically healthy and strong before you enter into the phase of pregnancy.

Dr Turner will also assess your partner's personal and family history and give healthy lifestyle advice.

What is Pregnancy Planning

Pregnancy planning involves talking to Dr Turner prior to becoming pregnant. 

Some of the issues addressed by Dr Turner in pregnancy planning include:

• Medical conditions: A thorough medical examination before pregnancy helps in diagnosing any medical conditions that may affect the mother and baby such as diabetes, high blood pressure, anaemia, kidney disorders, thyroid diseases, and heart problems. Your physician will advise you on certain measures to control them.
• Infections and vaccinations: During pregnancy, the mother will be more susceptible to infections that can cause serious birth defects or illness in the baby. Tests are done to determine immunity against diseases such as German measles and chickenpox. If the expecting mother lacks antibodies against these diseases, then the doctor will advise vaccination before pregnancy.
• Immunisation: If the mother is a carrier of hepatitis-B virus, blood tests will be done to identify the virus and the child will be vaccinated at birth. Vaccination protects the foetus from hepatitis-B infections.Covid, influenza, chicken pox and whooping cough vaccinations will also be discussed.
• Medications: Women who are infected with human immunodeficiency virus (HIV) will be advised to take certain medications during pregnancy to decrease the risk of the foetus becoming infected with HIV.
• Hereditary disorders: In women with a family history of hereditary disorders such as haemophilia, sickle cell anaemia, cystic fibrosis, and thalassemia, the chances of a child developing these conditions is increased. Therefore, before planning for pregnancy, your doctor may suggest both mother and father undergo certain tests to identify these diseases. Screening for hundreds of genetic conditions is now available, and Dr Turner will discuss the possibility of doing this.
• Diet: Practising a healthy diet is very important before pregnancy. Dr Turner may suggest dietary changes and include supplements such as prenatal vitamins and folic acid. He will also advise avoiding alcohol, tobacco, and illicit drugs as they may harm the baby.
• Family health history: Inform Dr Turner about the presence of hereditary medical conditions and multiple births in the family.
• Reproductive history: Your doctor will discuss your menstrual history, use of contraceptives, previous sexually transmitted diseases, vaginal infections and Pap test results.
• Weight: It is always better to have an ideal weight before conception. Gaining weight if you are underweight will reduce the risk of having a low birth-weight baby, and reducing weight if you are overweight will prevent the risk of high blood pressure and diabetes during pregnancy.
• Workplace and home environment: Dr Turner will discuss potential hazards to the conception or maintenance of pregnancy, such as exposure to lead or certain toxic solvents, radiation and cat faeces.
• Lifestyle: The effect of certain habits like alcohol consumption, smoking and use of recreational drugs on pregnancy will be discussed. You and/or your partner may be advised to stop these habits for a healthy pregnancy.
• Exercise: Inform Dr Turner about the exercises you perform or if you don't exercise. Based on this, you may be advised to continue normal exercises during pregnancy until Dr Turner suggests otherwise.

Older Women Counselling

Advice for older women: Women older than 35 years of age will be advised on the risks of

• Infertility,
• Abnormalities in the child; and
• Pregnancy complications, such as miscarriage and labour problems.

Possible Recommendations

Dr Turner may also recommend:

• Physical examination of your abdomen, heart, breasts, thyroid and lungs
• Pap smear and pelvic examination
• Lab tests to screen for hepatitis, HIV, rubella, syphilis and other conditions
• Chart menstrual cycles to monitor ovulation and determine the most favourable time to get pregnant
• Advise appropriate vaccinations against rubella or chickenpox, and recommend delay in conception for a month. He will also discuss influenza, covid and whooping cough vaccinations.
• Conduct genetic counselling for older mothers or those with a risk of hereditary diseases to help you understand the child's chances of birth defects or intellectual disability.
• Prenatal vitamins: You should take folic acid supplements before you conceive, as folic acid reduces the chances of neural tube defects in your baby. Iodine supplementation is also vital for foetal thyroid and neurological development.

Reducing the Risk Factors

Where Risk Factors are identified, some may not be controlled.

If you are suffering from a medical condition, Dr Turner can guide you with changes you need to make in your

• diet,
• medication, or
• other areas that will keep the disease in check.

You may be encouraged to lose weight before becoming pregnant.

Dr Turner may suggest folic acid supplements that prevent certain birth defects.

• As illegal drug use may affect the emotional and functional development of a baby, you should totally avoid them before and during pregnancy.
• A serious effect of consuming alcohol during pregnancy is foetal alcohol syndrome. So, women should stop drinking alcohol if they are planning a pregnancy.
• Some of the necessary dietary habits include using washed and properly cooked vegetables and avoiding certain kinds of fish (shark, swordfish) with high mercury levels.
• Care should also be taken to avoid exposure to toxic agents such as lead, mercury and radiation.
• Cats using a litter box can also be a source of infection, so have someone else empty the litter box during this time.

Preconception Genetic Screening

A preconception carrier test lets you know whether you and/or your partner are carriers of a disease, and helps you to make important pregnancy-related decisions.

An important step in such tests is identification of a carrier (a person with either mild or no symptoms of the disorder, but capable of passing on the disorder to his or her child through a particular gene).

Genetic Carrier Screening

If you are a carrier, you may decide to get pregnant with the option of considering prenatal diagnosis (diagnosis of abnormalities), use In vitro fertilisation to identify unaffected embryos and only use them, use donor sperm or eggs or even choose not to become pregnant.

Preconception Carrier Screening is a screening option, available for a couple planning to become pregnant, that allows her doctor to identify conditions that have the potential to adversely impact the health of her foetus (developing baby) in the future.

This is done at a point in time when the woman can have the widest range of personal and reproductive choices and helps to predict the possibility of having a child with a genetic disorder.

What Happens With Screening Tests

This involves both genetic counselling and laboratory testing

Genetic Counselling

In genetic counselling, a genetic counsellor goes through your family medical history, which helps them to determine if your baby is likely to have a genetic disorder based on the following:

• A history of genetic disorders runs in your family
• You have a genetic disorder
• You already have a child with a genetic disorder
• Your race or ethnicity

Laboratory Testing

Either blood and saliva samples are collected. They can be analysed for hundreds of genetic disorders using DNA Analysis